Review to determine whether second Emergency Department required in Mid-West


A review to determine whether a second Emergency Department is required, in the Mid-West region has been initiated by Health Minister, Stephen Donnelly.

The Department of Health  said a review into urgent and emergency care capacity in the mid-west will consider the case for a second Emergency Department for the region, in light of a big increase in the population in recent years and ongoing pressures at the Emergency Department at University Hospital Limerick (UHL).

Smaller Emergency Departments in the region closed 15 years ago. The Department of Health said this was based on the very clear clinical advice at the time, as there was a clear relationship between emergency teams providing high volume of service and better outcomes. The aim was to minimise the risk of a patient presenting at the Emergency Department whose time critical needs exceeded the capacity of the hospital, and specialties needed, to treat them.

“We also know that important services, including intensive care units, require a certain throughput so that clinicians can maintain their skills.

Since those clinical decisions were made, the population in the Midwest has grown considerably. The population is also older than it is in most other regions. Older populations have a greater need for urgent and emergency care.”

The Department said there had been record increases in investment in UHL during the lifetime of this government. However, overcrowding at UHL’s emergency department continued, with trolley numbers increasing by 39% so far this year. This contrasted with the national trend, with the average morning trolley count falling by 11% during the first four months of the year. Some hospitals continually had no patients on trolleys.

“Investment in additional capacity includes:

  • Staffing at the hospital has grown by over 1,183 since the end of December 2019/early 2020 – from 2,814 to 3,997 at the end of February 2024. That represents an increase in staffing of 42%.
  •  There has been a 44% increase in the UHL budget in 5 years. In 2019, UHL had a Budget of €265 million. This year, 2024, the budget is €382 million, meaning its Budget has grown by €117 million.
  • 150 new beds have been opened in the UL Hospital Group (ULHG) since Jan 2020. This includes 108 beds in UHL (98 ward beds and 10 critical care). sT

“Investment has also included additional capacity at St. John’s, Croom Orthopaedic, Ennis and Nenagh hospitals.

“While some reforms are underway at UHL, significant changes are still required in terms of how UHL is run and how patient flow is managed. This was highlighted in the recent report by HIQA. HIQA noted evidence of improvements in operational efficiencies, but said greater operational grip was also needed.

“The Review will consider the additional capacity being added, as well as future reforms that are needed.”